Tuesday, 13 August 2013

What is Fibromyalgia?

A diagram of the tender points apparent in Fibromyalgia from Arthritis Research UK

Now I know a lot of you will know exactly what Fibromyalgia is, unfortuntely, and I mean unfortunately if you are suffering from it- because then you know all too well what the condition entails. But in the purposes of education and in light of my recent 'diagnosis' I thought I'd write a post on it, as I promised I would. If anything it will help to educate me too and the more answers and information that I have the more that I can help myself. Remember knowledge is power.

Fibromyalgia can be commonly referred to as FM. So as I said in my post 'the rheumatologist appointment' some doctors and clinicians will class fibromyalgia in the same 'umbrella' as ME. But I would say that is only really possible if you already have ME, because established ME can lead to a diagnosis of fibromyalgia (more to be said on that later). However it is possible to have fibromyalgia on it's own.In fact fibromyalgia is thought to to be quite common. According to Arthritis Research UK that figure could be as high as 1 in every 25 people may be affected. Quite a shocking figure really. Surpassing figures for rheumatoid arthritis and it can be just as painful if not more so. But at the same time I fear that with such a high figure it could trivialise the condition somewhat. In terms of coming across many people that would say "Oh I have fibromyalgia and I just get on with it" type situations, as I'm sure many people have come across. However there is of course varying degrees of the severity of the condition and of some of the other symptoms that can be associated with the condition.


So let me actually answer the question 'what is fibromyalgia?' Well answer it as much as it can be answered. Fibromyalgia is a condition that effects the muscles, tendons and ligaments, causing widespread pain. In order for it to be diagnosed you need to have been experiencing the pain 'long term,' ruling out any injuries etc where the muscles should have repaired themselves. Thus rendering it a chronic condition. The Fibromyalgia Association UK describes the composite of the name fibromyalgia as '"fibro" for fibrous tissues such as tendons and ligaments "my" indicating muscles and "algia" meaning pain.' So quite self explanatory really. Fibromyalgia is also recognized as a syndrome which again the Fibromyalgia Association define as 'a collection of symptoms rather than one specific symptom or malfunction.' This can also make conditons hard to treat as there are many things to take into consideration. 


Fibromyalgia can also be recognised by pain in certain tender points that can be seen on the photo at the top of this post. These areas can be extremely tender to the touch, even gently as I think I have conveyed clearly in many a whiney post and is the reason I am writing this post on my phone, because I can't handle the weight of my tablet on my legs. Someone with fibromyalgia will usually have 11 or more tender points. The pain will vary in severity from time to time but can be described as an aching pain or a burning sensation. Often it can feel like having sunburn. I quite often feel like my muscles are pulling away from my bones, which is probably a sign of the tension in the muscles. The pain can prevent sleep and can cause nausea.


Although pain is the key symptom of the condition as I said it is a syndrome so there are other symptoms that again vary according to each patient. Namely fatigue but other symptoms as well as pain of course include:

*sensitivity to touch

*sensitivity to hot and cold

*sleep disturbances

*poor circulation

*sweating

*swellings

*tingling 

*headaches

*low mood

*forgetfullness and poor concentration

*irratible bowel syndrome

Just to name a few but there can be plenty more. So fibromyalgia can be diagnosed by the long term presence of pain, especially in the tender points and the existence of other symptoms and then of course ruling out other conditions such as rheumatoid arthritis, MS or a vitamin defiency. A blood test for muscle damage and wastage as well as to look for any inflammation is usually the first port of call. This is because research has shown that fibromyalgia is not a degenerative (where the muscles waste) or inflammatory condition. This also means to use a highly annoying phrase 'that there is no physical reason for the pain'. As I explained before the pain felt through fibromyalgia is a hypersenitivity in the way our brains process pain signals. So for example feeling in agony by doing something that should not hurt.    But of course that doesn't mean that it's all in our heads the pain is still very real and should be treated as such. In particular using drugs that will help hypersensitivity and how the brain is processesing the pain signals.


As I mentioned in the post 'the rheumatologist appointment' fibromyalgia can be caused by a sleep disturbance and thus not getting enough restorative sleep. Leaving our muscles unrefreshed and the reason for all over fatigue too in fibromyalgia sufferers. Therefore the treatment for fibromyalgia is often sought in helping the patient get better sleep. Through medicines such as amitriptiline and also lifestyle changes like establishing a sleep routine. More information on trying to aid better sleep can be found in my post 'things I learnt at clinic: physiology and sleep.'


In the booklet that I recieved from the rheumatologist it tells of an 'experiment where healthy volunteers were woken during each period of deep sleep, a number of them developed the typical signs and symptoms of fibromyalgia." Demonstrating clearly the connection between sleep disturbance and fibromyalgia but also the importance of sleep on our overall health. However as these were healthy candidates their symptoms soon eased once there sleep pattern went back to normal. But because many people with fibromyalgia also have other health issues such as ME, that can play havoc with sleep patterns, or a long standing sleep disturbance that has gone undetected and untreated our bodies won't heal as fast. Or without getting the quality of sleep needed to help the body heal and treat the other symptoms. But other causes are thought to be after a viral infection, physical or mental trauma such as a car accident or bereavement, or following a long period of stress and anxiety.


So some treatments that are available for fibromyalgia sufferers are:
*pain killers
* drugs to help with pain and sleep
* antidepressants to help with anxiety or depression which could again could cause sleep disturbances
* Medication like gabapentin, which affects the pain signals

Other than medicines though there is:
* physiotherapy
* occupational therapy
* gentle excercise (note I say gentle! But again depending on the severity of symptoms in each individual)
* healthy eating
*mindfulness
*a good sleep routine

As well as complimentary therapies such as:
*massage
*aromatherapy
* accupuncture
* reflexology

Find something that works for you and helps improve your pain levels. Remember what works for one person may not work for another but hopefully there is something for everyone. It is just that fibromyalgia varies between sufferers. And like I have said before don't be afraid to visit your doctor frequently and to find a doctor that will work with you and is easy to talk to. Make sure they have the full picture in order to give you the best treatment for you. 


So there you have it some information on fibromyalgia. I hope that it has been informative. Below are some websites for further information.

Www.fibromyalgia-association.org
Www.fibro-wales.com
Www.fibroaction.org
Www.arthritisresearchuk.org

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